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<p>Patients who use injectables like semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro) to lose weight will eventually experience a point where their weight stabilizes, just as with any other treatment. This phase is referred to as a “plateau,” during which the body establishes a new equilibrium, and weight, as well as other metabolic markers like blood pressure and HBA1c, stabilize or only fluctuate slightly. Some people may notice a gradual increase in appetite during this phase, while others may maintain their current weight.</p><p><a data-mce-href="https://classic.clinicaltrials.gov/ct2/show/NCT05822830" href="https://classic.clinicaltrials.gov/ct2/show/NCT05822830" data-mce-selected="inline-boundary">Studies</a> have indicated that, on average, this plateau occurs at around a little over a year with semaglutide. Nevertheless, it can be surprising for some patients to learn that there’s a limit to what these medications can achieve. Everyone will eventually reach a plateau, but it’s challenging to predict when and how much weight loss will occur when starting the medication.</p><p>This plateau phenomenon is not unique to these medications; it occurs in various medical scenarios. For example, blood pressure medications won’t continue reducing blood pressure indefinitely, and diabetes medications won’t keep lowering blood glucose levels forever. This natural balance is essential for our health, preventing extreme changes.</p><figure id="figure-wf4ijjwylfln04y5p4"><img id="wf4ijjwylfln04y5p4" src="https://images.unsplash.com/photo-1537977193203-d4fce971cb5e?crop=entropy&amp;cs=tinysrgb&amp;fit=max&amp;fm=jpg&amp;ixid=M3wyNjI5NjF8MHwxfHNlYXJjaHwyN3x8TWVkaWNhbCUyMHdlaWdodGxvc3N8ZW58MHx8fHwxNjk1NzIxNTQyfDA&amp;ixlib=rb-4.0.3&amp;q=80&amp;w=1080" alt="" class="object-cover bg-gray-100 rounded-sm md:rounded-md lg:rounded-lg" style="aspect-ratio: 16/9; object-position: center center;" data-corners="default" data-aspect="16:9" data-caption="" data-positionx="undefined" data-positiony="undefined" data-mce-src="https://images.unsplash.com/photo-1537977193203-d4fce971cb5e?crop=entropy&amp;cs=tinysrgb&amp;fit=max&amp;fm=jpg&amp;ixid=M3wyNjI5NjF8MHwxfHNlYXJjaHwyN3x8TWVkaWNhbCUyMHdlaWdodGxvc3N8ZW58MHx8fHwxNjk1NzIxNTQyfDA&amp;ixlib=rb-4.0.3&amp;q=80&amp;w=1080" data-mce-style="aspect-ratio: 16/9; object-position: center center;"></figure><p><br></p><p>While it’s unclear what factors predispose some patients to longer or shorter responses to GLP-1 agonists, early responses often indicate later outcomes. Patients who experience significant weight loss on lower doses of semaglutide, for instance, may remain on a lower dose for an extended period. Patients with a history of childhood obesity or suspected genetic factors may be more prone to a subdued response.</p><p>Clinicians emphasize the importance of discussing these expectations, including potential plateaus and non-responses, with patients before prescribing these medications. <a data-mce-href="https://www.medpagetoday.com/endocrinology/obesity/102417" href="https://www.medpagetoday.com/endocrinology/obesity/102417">Clinical trials</a> have shown that weight loss tends to taper off after a certain duration, and individual responses can vary widely due to factors such as medical history and medications.</p><p>In the future, research may focus on identifying characteristics, like genetics, to predict patient responses to GLP-1 agonists, reducing the trial and error involved in treatment. This personalized approach could streamline the prescribing process and save time and resources for both patients and healthcare providers.</p><p>Patients’ desires and societal pressures often conflict with clinical realities. Many patients aim for specific weight loss goals, sometimes unrealistic ones, despite achieving positive health outcomes with GLP-1 agonists. Clinicians have strategies to address plateaus, such as increasing doses or adding complementary medications like phentermine (Lomaira). However, “drug holidays” or stopping and restarting GLP-1 agonists typically don’t break plateaus.</p>

The Unspoken Plateau of GLP-1 Agonists”

Blur image of medical team and patient during local anesthesia for surgery to treatment in operating room at the hospital.

<p>Anesthesiologists are deeply divided on how to manage the increasing number of surgical patients taking GLP-1 receptor agonists. These medications elevate the risk of aspiration during surgery. While the prominent U.S. anesthesiology society recommends that patients stop using injectable forms of these drugs for seven days before surgery, some anesthesiologists are exploring alternative approaches, such as intubating all high-risk patients, even for minor procedures. Others are advocating for patients to discontinue these medications for weeks, not just days, or gradually reduce their doses.</p><p>This issue is currently a subject of intense debate within the anesthesia community, and opinions are sharply divided.</p><p>Last autumn, a patient on injectable semaglutide (known as Ozempic for type 2 diabetes and Wegovy for weight loss) who experienced regurgitation of stomach contents while sedated for a lumpectomy. Typically, medical professionals minimize aspiration risk by requiring patients to fast before scheduled surgery to ensure their stomachs remain empty.</p><p>In theory, their stomachs should be fairly empty, However, GLP-1 agonists, including the popular semaglutide, can significantly disrupt normal digestive processes. Users’ stomachs may not empty within the usual 90 minutes to 2 hours after a meal. This slower gastric emptying can cause patients to feel fuller, potentially leading to regurgitation of lingering food from days ago while they are under anesthesia and unable to cough to prevent airway blockage.</p><p>This situation increases the risk of food being inhaled into the lungs, a rare but severe event associated with a high likelihood of death or severe injury.</p><p>Anesthesiologists are deeply concerned to the point that “the anesthesia plan for any surgery involving a patient on these medications could be affected,” Some anesthesiologists are now considering intubation for patients on these drugs even for minor procedures and employing techniques usually reserved for high-risk aspiration cases.</p><p>Alarm has risen among anesthesiologists as the number of regurgitation cases has increased among surgery patients taking GLP-1 receptor agonists. In a distressing incident in October 2022, a 48-year-old woman undergoing a lumpectomy in Toronto began to regurgitate while under anesthesia, despite fasting from solid food for 20 hours and clear fluids for 8 hours.</p><p>Describing the incident, a case report published in the Canadian Journal of Anesthesia, stated, “It was very dramatic.” He and the medical team took immediate steps to ensure that stomach contents didn’t enter her airway, followed by intubation, and a bronchoscope inspection of her lungs. Fortunately, no stomach contents entered her airway.</p><p>While there haven’t been reported deaths resulting from aspiration during surgery after taking GLP-1 agonists, another case report in the same journal from Boston described a more troubling incident. An endoscopy patient on weekly semaglutide injections aspirated food from the stomach into the trachea and bronchi despite fasting for 18 hours. The food was removed via bronchoscope before intubation.</p><p>Several anesthesiologists have reported encountering numerous patients taking GLP-1 agonists, including those undergoing minor procedures that typically do not require intubation, such as colonoscopies, upper endoscopies, and breast biopsies.</p><p>These drugs have surged in popularity due to reports in medical literature and mainstream media about significant weight loss among users, including celebrities. For instance, a retrospective study in 2022 tracked 175 Mayo Clinic patients and found they lost an average of 5.9% of their weight at 3 months and 10.9% at 6 months while using injectable semaglutide.</p><p>In addition to injectable semaglutide (Ozempic and Wegovy), these medications include the oral version of semaglutide (Rybelsus), dulaglutide (Trulicity), exenatide (Byetta and Bydureon), and liraglutide (Saxenda and Victoza). Tirzepatide (Mounjaro), a GIP/GLP-1 agonist, shares similarities.</p><p>Despite reports of side effects like nausea, diarrhea, constipation, sulfurous burps, and even unusual dreams about famous people, their sales have surged. Wegovy, approved for weight loss, reportedly saw a 344% increase in U.S. sales during the first 6 months of the year.</p><p>Meanwhile, recent research has revealed how significantly these drugs slow down the digestive system. In one study, researchers in Slovenia administered injectable semaglutide or a placebo to 20 women with polycystic ovary syndrome and obesity for 12 weeks. At the study’s conclusion, 37% of meals remained in the stomachs of women taking the drug at 4 hours, compared to none in the placebo group.</p><p>Another study from Brazil found that upper endoscopy patients on semaglutide were significantly more likely than others to retain an abnormal amount of food in their stomachs despite fasting.</p><p>Strategies for managing this issue range from brief drug hiatuses to intubation. In a June 29 consensus statement, the American Society of Anesthesiologists (ASA) recommended that patients stop taking weekly doses of GLP-1 agonists for 7 days before procedures, with daily doses stopped for 1 day. For patients using GLP-1 agonists for diabetes management, consulting an endocrinologist for bridging antidiabetic therapy is advised if the drug needs to be held for a longer duration. The society maintains its existing fasting guidelines, as there is no evidence indicating the optimal fasting duration for patients on these drugs.</p><p>Dr. Daniel Cole, a UCLA anesthesiologist and former ASA president, supports these recommendations but notes their limited evidentiary basis. He emphasizes that the ASA is doing its best with the available data and that various approaches can be taken to protect patients.</p><p>At the McGovern Medical School at UTHealth Houston, Dr. Omonele Nwokolo and several colleagues are bypassing the ASA’s recommendations by intubating all patients using weight-loss drugs. The risk of dangerous or fatal pulmonary aspiration is substantial enough to warrant extra precautions, according to Nwokolo. Intubation is typically reserved for longer and more painful surgical procedures or emergencies where fasting history is unclear, and it must be assumed that patients’ stomachs are full. Nwokolo and colleagues employ rapid sequence induction, a technique used for specific situations such as emergent procedures and cases with fasting concerns.</p><p>However, Dr. Kathryn Cobb, a University of North Carolina anesthesiologist, cautions that intubation is not always a straightforward option, especially in procedural settings without anesthesia machines geared for intubation, where intubation is reserved for emergencies.</p><p>Dr. Cole adds that intubation carries risks like mouth and teeth damage, increased anesthetic doses impacting heart and vascular function, and delayed cognitive recovery.</p>

Inform Your Anesthesiologist About GLP-1 Agonist Usage

Extreme close up macro shot of a yellow disposable insulin injector or syringe with a mounted needle at the tip. 

<p>A small case series suggests that using a GLP-1 receptor agonist, such as semaglutide, at an early stage of type 1 diabetes may reduce the reliance on insulin. In this study, ten adults recently diagnosed with type 1 diabetes initially received a weekly dose of 0.125 mg of semaglutide, which was adjusted up to a maximum of 0.5 mg per week as their prandial (mealtime) insulin doses were reduced.</p><p>Within just 3 months of starting semaglutide, all ten patients were able to completely discontinue their prandial insulin. Within 6 months, seven patients were also able to eliminate their basal (background) insulin. These findings were reported by Dr. Paresh Dandona and colleagues from the State University of New York at Buffalo in a New England Journal of Medicine correspondence.</p><p>The researchers noted that these initial observations support the need for larger, prospective, randomized clinical trials to further investigate this approach. It’s worth mentioning that while GLP-1 receptor agonists like semaglutide are commonly used for type 2 diabetes and obesity, none of them, nor SGLT2 inhibitors, are currently FDA-approved for type 1 diabetes. This is often due to concerns about the risk of diabetic ketoacidosis and hypoglycemia associated with their potent glucose-lowering effects.</p><p>The patients in this case series, aged 21 to 39, were followed from 2020 to 2022. Half were female, predominantly white, with an average baseline BMI of 25.1. Most presented with diabetic ketoacidosis or classic diabetes symptoms like excessive thirst, urination, and weight loss. Nine of the patients had antibodies against glutamic acid decarboxylase, a marker of autoimmune diabetes, and one had autoantibodies against islet antigen 2.</p><p>Semaglutide treatment began within 3 months of diagnosis, as many new-onset type 1 diabetes patients still have functioning beta cells. While adjusting medication doses, carbohydrate intake was restricted for all patients.</p><p>HbA1c levels decreased significantly, from an average of 11.7% at baseline to 5.9% at the 6-month mark on semaglutide. This continued to drop slightly to 5.7% at 12 months. Patients on semaglutide also experienced a notable increase in fasting C-peptide levels, indicating improved insulin production, and spent the majority of their time within the target glucose range as measured by continuous glucose monitoring.</p><p>The researchers acknowledged the absence of a control group but compared their HbA1c data with control groups from other studies involving early type 1 diabetes patients. These studies showed an initial improvement in HbA1c during the first 6 months, followed by an increase, consistent with the end of the “honeymoon period” in early type 1 diabetes treatment.</p><p>Mild hypoglycemia was observed during the semaglutide dose titration, but once the dose stabilized, no patients experienced hypoglycemic episodes or diabetic ketoacidosis. The baseline insulin doses were also recorded for reference.</p>

Semaglutide Can Ease The Insulin Need in T1DM

Portrait of woman  holding slim pills and a glass of water., Weightloss, Diet concept

<p>GLP-1 agonist drugs have been a game-changer in the treatment of type 2 diabetes, and exciting new developments are on the horizon. These medications work by mimicking the action of a hormone called glucagon-like peptide-1 (GLP-1), which helps regulate blood sugar levels. By activating the GLP-1 receptor, these drugs stimulate insulin production, suppress glucagon release, and slow down digestion, leading to improved glycemic control.</p>

<h2>What are GLP-1 Agonist Drugs?</h2>

<p>GLP-1 agonist drugs are a class of injectable medications used to lower blood sugar levels in people with type 2 diabetes. They are typically prescribed when other oral medications or insulin therapy alone are not sufficient to achieve glycemic targets.</p>

<h3>How do GLP-1 Agonists Work?</h3>

<p>GLP-1 agonists work by increasing the production and release of insulin from the pancreas, reducing the amount of glucose produced by the liver, and slowing down the absorption of glucose from the gut. These actions help to lower blood sugar levels and improve overall glycemic control.</p>

<h3>Benefits of GLP-1 Agonist Drugs</h3>

<p>GLP-1 agonist drugs have several benefits that make them an attractive option for the treatment of type 2 diabetes. Some of these benefits include:</p>

<ul>
  <li>Effective blood sugar control</li>
  <li>Weight loss</li>
  <li>Cardiovascular benefits</li>
  <li>Reduced risk of hypoglycemia</li>
</ul>

<p>These medications have been shown to not only lower blood sugar levels but also promote weight loss, which can be beneficial for individuals with type 2 diabetes who are overweight or obese.</p>

<h2>New Developments in GLP-1 Agonist Drugs</h2>

<p>The field of GLP-1 agonist drugs is constantly evolving, with new medications being developed to further improve glycemic control and offer additional benefits to patients.</p>

<h3>1. Once-Weekly Formulations</h3>

<p>Currently, most GLP-1 agonist drugs require daily injections. However, pharmaceutical companies are working on developing once-weekly formulations that would provide the same benefits with fewer injections. This would greatly improve convenience and adherence to treatment.</p>

<h3>2. Oral GLP-1 Agonists</h3>

<p>Another exciting development is the potential for oral GLP-1 agonist drugs. Currently, GLP-1 agonists are only available as injectable medications. However, researchers are exploring the possibility of developing oral formulations, which would be more convenient and easier to administer.</p>

<h3>3. Combination Therapies</h3>

<p>GLP-1 agonist drugs are often used in combination with other diabetes medications to achieve optimal glycemic control. Pharmaceutical companies are investigating the use of combination therapies that include GLP-1 agonists and other drugs, such as SGLT2 inhibitors, to provide even greater benefits to patients.</p>

<p>These new developments in GLP-1 agonist drugs hold great promise for the future of diabetes treatment. With improved convenience, efficacy, and additional benefits, these medications have the potential to revolutionize the management of type 2 diabetes.</p>

<h2>Conclusion</h2>

<p>GLP-1 agonist drugs have already made a significant impact in the treatment of type 2 diabetes, and the future looks even brighter. With the development of once-weekly formulations, oral options, and combination therapies, patients can look forward to more convenient and effective treatment options. As research continues, we can expect further advancements in GLP-1 agonist drugs that will continue to improve the lives of individuals living with type 2 diabetes.</p>

New GLP-1 Agonist Drugs are on the Way!

<p>When it comes to managing diabetes, there are several medications available in the market. One such medication is Ozempic, which has gained popularity for its effectiveness in controlling blood sugar levels in patients with type 2 diabetes. However, many people wonder if the National Health Service (NHS) offers Ozempic or other similar medications.</p><h2>NHS Medication Coverage</h2><p>The NHS provides a wide range of medications to patients, including those for diabetes management. However, the availability of specific medications may vary depending on various factors, such as clinical guidelines, cost-effectiveness, and individual patient needs.</p><h3>Diabetes Medications Covered by NHS</h3><p>The NHS offers a comprehensive range of medications for diabetes management. This includes:</p><ul><li>Metformin</li><li>Sulfonylureas</li><li>Thiazolidinediones</li><li>DPP-4 inhibitors</li><li>SGLT2 inhibitors</li><li>GLP-1 receptor agonists</li><li>Insulin</li></ul><p>These medications are prescribed based on individual patient needs and the stage of diabetes they are in.</p><h2>Ozempic and NHS Coverage</h2><p>Ozempic is a GLP-1 receptor agonist that has shown promising results in managing blood sugar levels in patients with type 2 diabetes. However, its availability on the NHS may vary.</p><p>The NHS has specific guidelines in place for prescribing Ozempic. Typically, it is prescribed when other medications have not been effective in controlling blood sugar levels or when patients are unable to tolerate other treatments.</p><h3>Consultation with Healthcare Professionals</h3><p>If you are interested in trying Ozempic or any other specific medication, it is important to consult with your healthcare professional. They will assess your individual needs and determine the most suitable treatment options for you.</p><p>During your consultation, your healthcare professional will consider various factors, including your medical history, current medications, and any potential side effects or contraindications.</p><h2>Conclusion</h2><p>The NHS offers a wide range of medications for diabetes management, including Ozempic. However, the availability of specific medications may vary depending on individual patient needs and NHS guidelines. It is essential to consult with your healthcare professional to determine the most suitable treatment options for you.&nbsp;</p><p>Remember, effective diabetes management involves a holistic approach that includes medication, lifestyle modifications, and regular monitoring. By working closely with your healthcare team, you can find the most appropriate treatment plan to help you manage your diabetes effectively.</p><p>For weightloss purposes, NHS doesn't cover Ozempic treatment but you can purchase online from CQC regulated and registered clinics like us. We provide online consultation, prescriptions and medications which will be delivered to your door.</p><figure id="figure-yz1gkrgajlkvimjs3"><img id="yz1gkrgajlkvimjs3" src="https://images.unsplash.com/photo-1683713881012-4c3fb63d0dd2?crop=entropy&amp;cs=tinysrgb&amp;fit=max&amp;fm=jpg&amp;ixid=M3wyNjI5NjF8MHwxfHNlYXJjaHwxMXx8ZGlhYmV0ZXMlMjBtZWRpY2F0aW9ufGVufDB8fHx8MTY5MTA4ODgyOXww&amp;ixlib=rb-4.0.3&amp;q=80&amp;w=1080" alt="diabetes medication" class="object-cover bg-gray-100" style="aspect-ratio: 16/9;" data-mce-src="https://images.unsplash.com/photo-1683713881012-4c3fb63d0dd2?crop=entropy&amp;cs=tinysrgb&amp;fit=max&amp;fm=jpg&amp;ixid=M3wyNjI5NjF8MHwxfHNlYXJjaHwxMXx8ZGlhYmV0ZXMlMjBtZWRpY2F0aW9ufGVufDB8fHx8MTY5MTA4ODgyOXww&amp;ixlib=rb-4.0.3&amp;q=80&amp;w=1080" data-mce-style="aspect-ratio: 16/9;"></figure><p> <br>
Image Source: Unsplash.com</p>

Does NHS Offers Ozempic or Other Medications?

Miniature elderly group walking on insulin pen,medical concept

<p>Diabetes is a chronic disease that affects millions of people worldwide. In the UK alone, it is estimated that over 4 million people have diabetes, with around 90% of them having type 2 diabetes. While there are several medications available to manage diabetes, a new drug called Ozempic has been making waves in the medical world for its potential to not only manage diabetes but also aid in weight loss.</p><h2>What is Ozempic?</h2><p>Ozempic is a medication that is used to treat type 2 diabetes. It is a once-weekly injection that contains semaglutide, a GLP-1 receptor agonist. GLP-1 receptor agonists are a type of medication that helps to lower blood sugar levels by increasing insulin secretion and reducing glucagon secretion. </p><p>However, what makes Ozempic unique is its potential to aid in weight loss. Studies have shown that people who take Ozempic can lose up to 5-10% of their body weight over a period of 6 months. This is because Ozempic works by suppressing appetite and reducing food cravings, which can lead to a reduction in calorie intake.</p><h2>Why are UK diabetes patients missing out on Ozempic?</h2><p>While Ozempic has been approved for use in the UK, it is not currently available on the NHS. This means that patients who want to take Ozempic have to pay for it themselves, which can be expensive. The cost of Ozempic can range from £50 to £150 per injection, depending on the dose and the pharmacy.</p><h3>The cost of Ozempic</h3><p>The high cost of Ozempic means that many diabetes patients in the UK are missing out on the potential benefits of this medication. While some patients may be able to afford the cost of Ozempic, others may not have the financial means to pay for it. This can lead to health inequalities, as those who cannot afford Ozempic may not have access to the same level of care as those who can.</p><h3>Alternative treatments for diabetes and weight loss</h3><p>For those who cannot afford Ozempic, there are alternative treatments available for diabetes and weight loss. These include lifestyle changes such as diet and exercise, as well as other medications such as metformin and GLP-1 receptor agonists such as liraglutide. However, it is important to note that these treatments may not be as effective as Ozempic in terms of weight loss.</p><h2>The potential benefits of Ozempic</h2><p>Despite the high cost of Ozempic, many diabetes patients are still interested in taking this medication due to its potential benefits. In addition to aiding in weight loss, Ozempic has also been shown to reduce the risk of cardiovascular events such as heart attacks and strokes. This makes it a promising medication for those with diabetes who are at a higher risk of developing these conditions.</p><h3>The need for access to affordable medications</h3><p>The high cost of medications like Ozempic highlights the need for affordable access to healthcare. It is important that all patients have access to the medications they need to manage their conditions, regardless of their financial situation. This is especially true for chronic conditions like diabetes, which require ongoing management and treatment.</p><h2>Conclusion</h2><p>Ozempic is a promising medication for diabetes patients who are looking to manage their condition and lose weight. While its high cost may be a barrier for some patients, it is important that all patients have access to affordable healthcare. As more research is conducted on the potential benefits of Ozempic, it is likely that we will see more widespread use of this medication in the future.</p><figure id="figure-yjc7dnxjw8lksrnqu5"><img id="yjc7dnxjw8lksrnqu5" src="https://images.unsplash.com/photo-1500420986994-e4ad8f630fee?crop=entropy&amp;cs=tinysrgb&amp;fit=max&amp;fm=jpg&amp;ixid=M3wyNjI5NjF8MHwxfHNlYXJjaHwxM3x8b3plbXBpYy1kaWFiZXRlc3xlbnwwfHx8fDE2OTA5MjI2MDN8MA&amp;ixlib=rb-4.0.3&amp;q=80&amp;w=1080" alt="ozempic-diabetes" class="object-cover bg-gray-100" style="aspect-ratio: 16/9;" data-mce-src="https://images.unsplash.com/photo-1500420986994-e4ad8f630fee?crop=entropy&amp;cs=tinysrgb&amp;fit=max&amp;fm=jpg&amp;ixid=M3wyNjI5NjF8MHwxfHNlYXJjaHwxM3x8b3plbXBpYy1kaWFiZXRlc3xlbnwwfHx8fDE2OTA5MjI2MDN8MA&amp;ixlib=rb-4.0.3&amp;q=80&amp;w=1080" data-mce-style="aspect-ratio: 16/9;"></figure><p> </p>